Which therapy is commonly used for status migrainosus in a hospital setting?

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Multiple Choice

Which therapy is commonly used for status migrainosus in a hospital setting?

Status migrainosus is a migraine attack lasting more than 72 hours that does not respond to standard outpatient therapy. In the hospital, a common abortive approach uses dihydroergotamine given IV or intranasally because it strongly constricts cranial vessels and disrupts the migraine pain pathway. Because ergots can cause vasospasm and other side effects, this treatment is typically paired with an antiemetic such as metoclopramide and IV fluids, with monitoring for signs of vasospasm, especially in patients with vascular risk. Other options like oral acetaminophen lack the potency needed for a prolonged, severe attack, intravenous caffeine is not a primary abortive choice for this scenario, and topical lidocaine has no systemic effect to treat a migraine.

Status migrainosus is a migraine attack lasting more than 72 hours that does not respond to standard outpatient therapy. In the hospital, a common abortive approach uses dihydroergotamine given IV or intranasally because it strongly constricts cranial vessels and disrupts the migraine pain pathway. Because ergots can cause vasospasm and other side effects, this treatment is typically paired with an antiemetic such as metoclopramide and IV fluids, with monitoring for signs of vasospasm, especially in patients with vascular risk. Other options like oral acetaminophen lack the potency needed for a prolonged, severe attack, intravenous caffeine is not a primary abortive choice for this scenario, and topical lidocaine has no systemic effect to treat a migraine.

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